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Technique and complications of percutaneous endoscopic gastrostomy in children
P M Davidson1, A G Catto-Smith, S W Beasley
1Department of Paediatrics, John Hunter Hospital, Newcastle, New South Wales, Australia.
Insights
Percutaneous endoscopic gastrostomy (PEG) is a common procedure in children. Refinements in technique can reduce complications like wound infections and reflux after PEG tube placement.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Percutaneous endoscopic gastrostomy (PEG) is an established procedure for children.
- The study analyzes technical issues and complications in pediatric PEG insertions.
Purpose of the Study:
- To analyze technical problems and complications associated with pediatric PEG insertion.
- To identify potential improvements in PEG insertion techniques to minimize adverse events.
Main Methods:
- Retrospective analysis of 63 pediatric PEG insertions.
- Documentation of technical difficulties and post-procedure complications.
Main Results:
- Complications observed included wound infection, esophageal injury, and symptomatic gastro-esophageal reflux (GOR).
- Esophageal injury was likely linked to guide wire extraction during the procedure.
Conclusions:
- While PEG is well-established, technical refinements can decrease complication rates.
- Optimizing the PEG insertion technique is crucial for improving patient outcomes and safety in pediatric cases.
Abstract:
Percutaneous endoscopic gastrostomy (PEG) is now a well-established technique in children. In this study of 63 children (mean age 7.8 years, youngest 2.4 months), technical problems associated with insertion of the gastrostomy tube, and complications related to the procedure, were analysed. Complications included wound infection, oesophageal injury (probably sustained during extraction of the guide wire) and symptomatic gastro-oesophageal reflux (GOR) occurring after PEG insertion. Many of these complications can be avoided or reduced in likelihood by refinements to the technique of insertion.